Optimisation of arterial hypertension therapy in patients with metabolic disorders: aspect of fixed combination lipophilic of perindopril and amlodipine
Aim: To assess the effect of a lipophilic angiotensin-converting enzyme inhibitor (ACEI) in combination with a calcium antagonist (CA) on the 24-hour blood pressure (BP) profile, systemic inflammation in patients with arterial hypertension (AH) and metabolic disorders (MD). Methods: Fifty-eight pati...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Open Exploration Publishing Inc.
2025-06-01
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| Series: | Exploration of Medicine |
| Subjects: | |
| Online Access: | https://www.explorationpub.com/uploads/Article/A1001336/1001336.pdf |
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| Summary: | Aim: To assess the effect of a lipophilic angiotensin-converting enzyme inhibitor (ACEI) in combination with a calcium antagonist (CA) on the 24-hour blood pressure (BP) profile, systemic inflammation in patients with arterial hypertension (AH) and metabolic disorders (MD). Methods: Fifty-eight patients with the ≥ 2nd degree of AH was divided into 3 groups: patients with AH without metabolic syndrome (MS), patients with AH and MS, and patients with AH and diabetes mellitus (DM). Taking into account the BP profile characteristics, therapy with ACEI perindopril and CA amlodipine in a fixed combination (FC) was prescribed. The observation period for patients was 12 weeks. Results: A profile with an insufficient decrease in BP at night was more often detected in persons with MS having DM and nocturnal hypertension. In patients with AH and DM, the values of daily BP variability exceeded those in persons without MS (P < 0.05). Patients with MS had a higher concentration of high-sensitivity C-reactive protein (hsCRP) compared to patients without MS (3.5 mg/L; P < 0.01). Patients with DM and AH achieved target BP in 60% of cases during treatment: office BP decreased to 134.8 (17.97 kPa) ± 8.7/83.2 (11.09 kPa) ± 6.7 mmHg (∆ = –31/–16 mmHg), 90% of patients required maximum therapeutic doses of antihypertensive therapy (AHT). A decrease in the hsCRP concentration was detected (P < 0.05) in patients of groups 2 and 3, which showed practical possibility of average/maximum therapeutic doses influence on the activity of systemic inflammation (∆ = –12.8% in patients group 2 and ∆ = –11.2% in patients of group 3). Conclusions: A combination of a lipophilic ACEI and a vasoselective СA promotes good BP control, a decrease in the activity of systemic inflammation, and hypersympathicotonia in patients with MD. |
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| ISSN: | 2692-3106 |